| NPI | 1649330622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: GA RN042170) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: DC 64102) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2014-05-28 |